Patrick PaulDec 17, 2020 15:08:12 IST
A successful stem cell transplant from a matching blood stem cell donor can be lifesaving for patients who suffer from diseases like blood cancer, Thalassemia or Aplastic Anemia. Finding a matching stem cell donor is only half the battle and it is also equally important for the stem cells of the donor to actually reach the patient on time as delays in transplant can be life-threatening for a patient. Blood stem cells are collected from a donor in the same way a blood platelet donation is done.
But what happens to the stem cells after it has been collected from a donor?
Once a potential donor comes up as a match for a patient, the blood stem cells are collected via peripheral blood stem cell collection method, post which the medical team waits for the stem cell count from the laboratory. The amount of stem cell count which is to be collected from a donor is related to the number of stem cells required by the recipient. The stem cells cannot be released for transport unless the stem cell count has been sent from the lab and clearance has been given from the Collection centre physician.
The stem cells are stored at 2-8 degrees Celsius after the collection. As per the World Marrow Donor Association (WMDA) guidelines, the product must be transported between +1-10 degree Celsius and the viability of the stem cells between said temperatures is 72 hours.
The stem cells are transported in a special package called a ‘Credo Box’ that is prepped in advance to 4 degrees Celsius. The credo box maintains a temperature of 2-8 degrees Celsius for 100 hours. There are two temperature loggers on this box that records the temperature of the inside of the box every 15 minutes.
The transportation of stem cells is a carefully guided process that takes precision and training by the courier personnel. An interesting fact is that only a human courier can carry the product. The reason for this is that the viability of stem cells is 72 hours, which means that once the patient has been conditioned or their body has been prepped for a transplant, their immunity is very low. They should receive a transplant within that time frame or the consequences can be life-threatening. Therefore, it is extremely critical for the stem cells to be securely transported and delivered to the Transplant Centre within this timeframe.
Some guidelines followed while transporting blood stem cells are:
- Only a trained and experienced courier personnel verified by a stem cell registry can carry the stem cell product for domestic transplants.
- The stem cell product alone cannot travel via cargo, someone always must be with the product
- The stem cell product cannot go through an X-ray machine or a metal detector
- The stem cell product must travel in a container and within the temperature parameters as set by the WMDA
The process differs for domestic and international transplants. If the stem cells is for the international Transplant centre, the Transplant centre decides for the transport of the product. If the product is for a national Transplant centre, the local stem cell registry is responsible for the transport of the product from the Collection Centre to the Transplant Center.
After the product reaches the Transplant centre, it is brought back up to room temperature and infused into the patient. If the donor has consented to cryopreservation, then the product is cryopreserved and infused at the later date. With cryopreservation on -80 degree Celsius on carbon dioxide or -196 degree Celsius on liquid nitrogen blood stem cells can be stored for a long time.
The COVID-19 pandemic created a lot of challenges concerning blood stem cell donations due to the closing of borders, travel restrictions, quarantine guidelines, etc. Stem cell registries like DKMS-BMST came up with a unique solution of transporting the products without courier personnel but via the pilot in the cockpit. The product was handed over to the pilot via a courier at the airport, and the pilot would take the product into the cockpit. This also meant that most of the planes could be utilized, even cargo planes without constraints of flight schedules.
With rising blood cancer cases in India, a successful blood stem cell donation from a matching donor can help blood cancer patients receive a second chance at life. The first step to ensuring this is that people are aware of the process of blood stem cell donation and register as a potential blood stem cell donor!
The author is the CEO of the NGO DKMS BMST Foundation, India